Advance Care Planning Doesn’t Aid Quality of Life

MONDAY, August 2, 2018 — Advance care planning in frail older adults does not increase patient activation or quality of life, according to a study published in the June issue of the Journal of the American Geriatrics Society.

Anouk Overbeek, from the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues performed a cluster randomized controlled trial to determine the effectiveness of advance care planning (ACP) in frail older adults (101 care home residents participating in the Adjusted Respecting Choices ACP program) and community-dwelling adults receiving home care (100 controls). Participants were 75 years and older and capable of consenting to participation.

Based on the 77 intervention participants and 83 controls who completed the follow-up assessment, the researchers observed no statistically significant differences between the groups in patient activation or quality of life over the 12-month follow-up. The vast majority of intervention group participants (93 percent) completed an advance directive (AD), and 94 percent appointed a decision-maker versus control participants (34 and 67 percent, respectively; P < 0.001). There were no differences in the use of medical care.

“ACP did not increase levels of patient activation or quality of life but did increase completion of ADs and appointment of surrogate decision-makers,” the authors write.